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How to Recover Quickly from a Quadriceps Strain

Muscle injury. Man with sprain thigh musclesA quadriceps strain, also known as a quad pull or thigh strain, is a relatively common running injury.

Strains can range from a mild discomfort to a full blown tear of most of the muscle which can result in severe pain and the inability to run or walk. The injury typically happens when one or more of the quadriceps muscles become overloaded.

In this post you will discover the factors that increase your risk of straining your quadriceps, and learn specific strategies to implement during your rehabilitation and return to activity.

How to Recover Quickly from a Quadriceps Strain/Pull

A thigh strain or quadriceps strain is a tear in one of the four quadriceps muscles at the front of the thigh. These muscles consist of the vastus lateralis, vastus medialis, vastus intermedius, and the rectus femoris. The most common muscle to injure is the rectus femoris as it crosses both the hip and the knee joint (where the others only cross the knee joint via the patellar tendon).

In the case of a quadriceps injury, there is a strain (which is a small tear of the muscle). Like sprains, strains are also categorized as Grade I, II, or III. A minor strain is classified as a Grade I tear, whereas a complete rupture, or tear, is classified as a Grade III tear. Grade II tears are partial ruptures or tears. Severe Grade II and Grade III tears cause impaired muscle function and usually have associated bruising that occurs near the site of injury.

With a Grade I strain, you may be able to carry on running at the time of injury. Grade I injuries tend to be mild in that they tend to heal fully. With proper care and rehabilitation, the healing times can be reduced.

A Grade II or III strain will be severe enough that you will have to stop training or competition. Grade II tears can often be rehabilitated as well although the healing time is longer. Grade III tears may require surgical intervention.

Symptoms of a Quadriceps Strain/Pull:

  • Sudden sharp pain at the front of your thigh.
  • Swelling and bruising may develop.
  • A lump, bump or muscle spasms may occur.
  • In the case of a Grade III tear, a gap in the muscle may appear and you lose the ability to straighten your knee.

A quadriceps strain most commonly occurs during running or jumping (in particular during sudden movements or when quickly starting and stopping). However, you could just as easily pull your quadriceps while weightlifting, working in the yard or accidently stepping into a hole.

Factors that can increase your risk of straining your quadriceps include:

  • Not warming up prior to exercise.
  • Tightness in your hip flexors or quadriceps muscles.
  • Weakness in your glutes/buttock muscles.
  • Performing activities that are above your ability level.
  • Performing tasks that your quadriceps muscles are not accustomed to or haven’t performed before.

Initial Treatment

The course of treatment is dependent on the severity of the pain and the location of the injury. Please seek competent advice from a medical doctor, physical therapist or athletic trainer if you’re experiencing severe pain. A professional can assess the severity of the strain and address how to handle the injury.

For the purpose of this discussion, I will address a Grade I or minor Grade II injury. The initial course of treatment following the sprain includes PRICE, which stands for Protection, Rest, Ice, Compression, and Eelevation.

  • Protect. Initially, you may choose to “protect” the injury site. This may include the use of crutches to assist with walking. Even using a simple ACE wrap is a method of protecting the site from further injury. Refrain from an activity that may have caused the injury. Avoid aggressive stretching.
  • Rest. In this case, rest would indicate tapering down from your regular exercise activity or any activity that involves using your quadriceps (running, weightlifting, jumping or even excessively bending your knee).
  • Ice. Apply ice to the painful area. The rule for icing is to apply ice no more than twenty minutes per hour. Do not place the ice directly against the skin, especially if you are using a gel pack style. A bag of frozen peas can be ideal. Individuals with poor circulation or impaired sensation should take particular care when icing.
  • Compression helps to prevent and decrease swelling. Swelling can cause increased pain and slow the healing response, so limit it as much as possible. You can utilize a common ACE wrap.
  • Elevation. Compression and elevation may not be fully possible if the injury is located higher into the thigh. If there is swelling in the lower leg, then elevating the leg may be helpful.

During this acute phase, gently move the leg as you can tolerate. Don’t be aggressive with the movement. Walking is usually the best way to keep the area moving. Be sure to keep your steps shorter if you are experiencing pain. Keep to level ground. You may also try gently floating or walking in a pool as long as the pain does not worsen.

Depending on the severity of a Grade I or mild Grade II strain, the initial acute protection phase may last anywhere from three to five days and up to two weeks. Continue to monitor your symptoms closely as you progress into the sub-acute phase of treatment. If your pain increases or additional bruising occurs, you will need to taper back off your activity and possibly seek additional advice.

How to Self-Treat a Quadriceps Strain/Pull:

Mobilize the fascia and muscle tissue.

Work on restoring normal pain free movement of the leg. Start with mobilization of the areas above and below the injury site by using a Thera-Band Standard Roller Massager. Please refer to Mobilizations for a Quadriceps Strain.pdf. Be gentle and initially, do not mobilize over the site of injury. As pain decreases and you are tolerating mobilization over adjacent sites to the injury, you can gentle start mobilizing the injured area.

You are likely to experience tightness throughout the lower leg including the buttocks, hip flexors, and IT Band. You may also experience spine tightness or pain due to altered movement patterns in the lower extremity. I recommend using a foam roller to address tightness in the lower leg. Care should be taken, and don’t roll too aggressively on the site of the injury.

You may also utilize a tennis or lacrosse ball to mobilize the deeper hip and buttock muscles or to more deeply and aggressively mobilize the restricted areas appropriately. Take caution with any mobilization directly over the site of injury. This is healing tissue, and it needs to be treated like a healing scar. Initially, it will be fragile, but over time proper mobilization will help increase its strength and robustness.

Stretch

As you progress through your rehabilitation, care should be taken when stretching the quadriceps and hip flexors. I tend to utilize both mobilization and gentle stretching to help maintain quadriceps and lower leg motion. Don’t let the quadriceps become tight and restricted, but don’t be aggressive with your stretching either. The goal is to keep full range of motion in both the knee and hip joints. Pain may initially limit the full motion, but over time progress back into full range of motion.

Initiate a strengthening program

Any injured area will be weak initially. Slowly start progressing into strengthening the injured area. Focus on body weight exercise before returning to any weightlifting activities. Please refer to Strengthening and Rehabilitation Exercises for the Quadriceps.pdf. These exercises are listed easiest to hardest. Once you can easily perform them without pain or discomfort, then progress back into weightlifting activities. This process should be slow and graded.

Hydrate

The human body is primarily made of water, which is critical for all body functions. Hydrate more frequently during recovery. Adequate water intake is critical as your body attempts to heal and flush out metabolic wastes. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Keep steady supplies of nutrients going to/from the site of the injury. Try to avoid beverages that contain artificial sweeteners or chemicals with names you can’t spell or pronounce. Water is best.

Start a supplement

A quadriceps strain is typically associated with a specific event and an active inflammatory process typically occurs. I am a supporter of natural supplements and remedies. Many supplements include herbs which are designed to help reduce inflammation and support the healing response. My most recommended supplement to help recover from injury is CapraFlex by Mt. Capra. Another option would be Tissue Rejuvenator by Hammer Nutrition.

Protein

Consuming an adequate level of protein is necessary in order to repair injured tissues. I recommend eating additional plant based protein as well as protein from meat sources.

Return to Activity

Once your pain decreases and your hip and knee range of motion has returned to normal, slowly start tapering back into your training routine. During this time, you remain at a higher risk of injury. As you continue working through your rehabilitation and your return to activity, implement the following strategies:

  • Warm up prior to exercise. Increase your normal warm up time by at least 10 minutes in order to increase blood flow to the area. This allows for better mobility and also prepares the tissues for exercise. Use a self-massage tool or a foam roller to roll up and down the quadriceps as part of your warm up. If you perform quadriceps and hip flexor stretches, be mindful that prolonged static stretching before exercise may worsen performance. Warm up exercises may include light jogging, bicycling, rowing or any activity to get the heart rate up and the blood flowing in the lower legs. Be careful when performing any movement that puts the hip flexors and/or quadriceps in a stretched positon with speed or force.
  • mobilizationwiththerabandrollermassager

  • Cool down. After performing your exercise or activity, take the extra time to cool down and stretch. Focus on quadriceps stretching as well as general lower extremity mobility stretches. Use the same self-massage tools as you did during your warm up.
  • Initially avoid potential high risk activities. As your recovery progresses and you return to activity, initially avoid high risk activities that put the quadriceps muscle under heavy load or a very quick load. Progress slowly. If an activity begins to cause pain in the quadriceps, don’t push through it. Instead, stop and give your quadriceps more time to heal prior to trying it again. You should be pain free before you progress the intensity of the activity or sport. Quadriceps pulls have a high likelihood of re-injury if you rush the process.
  • Regain full strength and motion before returning to sport. Before a full return to sport or activity is initiated, you should have full lower leg and quadriceps mobility and strength without pain. If you continue to experience soreness or restriction, continue to work on your rehabilitation until the leg and quadriceps have returned to normal. Then initiate a full return to activity.

If you’re not experiencing relief and progressing in your recovery after two to three weeks of aggressively managing the symptoms, contact your medical doctor, physical therapist or athletic trainer for an assessment and help in managing the injury. The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area.

For additional information on common running injuries and how to self-treat, please visit www.thePhysicalTherapyAdvisor.com.

Disclaimer:  This article is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.

78 Responses to How to Recover Quickly from a Quadriceps Strain

  1. Ben Shatto August 31, 2017 at 8:39 pm #

    Thank you for your kind words. Good luck on your recovery!

  2. Kellie Hall November 4, 2017 at 2:21 pm #

    Thank-you for all of the detailed information. I typically weight train but did some sprinting while playing baseball with friends and family. Though my quads were tight, I trained as usual and cut out stretching/foam rolling due to a busy schedule. Well, I just strained both quads chasing a paper bag in the wind ha ha! I am hoping that if I follow your guidelines I’ll be feeling better soon 🙂

    • BenShatto November 4, 2017 at 3:00 pm #

      Geez…….well…….I guess the need for cross training is more important than we think 🙂 LOL. Sorry to hear about the quad strains. Good luck and wishing you a speedy recovery. Let us know if you have questions!

  3. Mapi November 14, 2017 at 8:07 pm #

    This morning I felt a sharp pain while working out my quads. Right away I knew I have pulled the muscle, stopped the activity, placed ice on the sore area and have rested with my elevated leg most of the afternoon. Still tonight hurts when extending the muscle and walking… After reading your most helpful article have accepted that may not be able to return to the gym at least until next week… Thank you for the detailed information and advice…

    • BenShatto November 14, 2017 at 9:39 pm #

      Mapi, I am so sorry to hear about your injury. Follow the advice in the article, rest and take it easy for a while and be sure to slowly taper up the activity once you feel able. One of the biggest mistakes after a muscle pull is trying to return to activity too soon without an appropriate recovery time. Again when you start to return to normal exercise and training be sure to taper slowly back up to your baseline. Don’t start back at the prior level right away. Good Luck!

  4. Wendy December 12, 2017 at 7:09 am #

    Great article! I’ve been struggling with quad pain while running and after for the last month or maybe even longer. Going to try these steps and see how it goes. Wendy

    • BenShatto December 12, 2017 at 7:27 pm #

      Wendy….Thank You for the compliment. Let us know how things are progressing and feel free to ask any follow up questions! Good Luck!

  5. Cathy December 17, 2017 at 9:27 am #

    Great advice, thank you!

  6. ronald February 13, 2018 at 1:57 pm #

    hie doc i am experiencing sharp thigh muscle pains which started after i ran a 100m sprint

    • BenShatto February 13, 2018 at 7:47 pm #

      Hi Ronald,

      That does sound like a possible quad strain. Follow the advice in the article and be sure you are pain free and have tapered back into exercise and running before attempting a full sprint. Muscle pulls are easily re-injured. Keep us posted.

  7. Rayna March 16, 2018 at 4:38 pm #

    Recently this afternoon at dance, I felt a sharp pain in my vastus medialis, and I think I might’ve torn it. I can’t stretch my leg without it hurting, and I have to limp to walk. What is the best thing to do? Would I need crutches? Thank you, and amazing article!

    • BenShatto March 16, 2018 at 8:37 pm #

      Hi Rayna, Sounds like you may have a strain or a tear. If it is painful to walk then I would recommend crutches. You want to be able to walk normally without pain or a limp, so if you need one or two crutches to do that, then I would do it. Otherwise, don’t over stretch it and just focus on gentle massage, ice, compression and rest as the article advises. Good Luck!

  8. Anthony Gill March 19, 2018 at 10:52 am #

    Hi, A month ago I slipped on a wet floor and ruptured my Vastus Lateralis ! I used the RICE technique and the pain went away but very stiff, continued with “gental” yoga. There is still a lump or bump on top of muscle that does not seem to be going. I ‘ve started a walk/run program which seems to work, no pain, good flexibility. I’m 74 years old and a competitive triathlete so should I Expect the healing stage to last longer and should I be concerned about the lump ? It’s about the size of a golf ball and there is no pain when squeezed.

    Thanks Tony.

    • BenShatto March 19, 2018 at 8:51 pm #

      Hi Anthony, Sounds like everything is going well for your recovery. It is always good to get your physicians opinion on the lump. But in my experience it is not uncommon to develop either a hematoma which in these cases is basically dried blood and some scar tissue over the injury site. This is not uncommon and can last for months before the body re-absorbs it. Occasionally the injury site may form a calcification within the muscle at the site of injury. Again no cause for concern. It usually goes away after many months. They are typically not painful and are benign. Either way if the lump is not getting bigger and is not painful it is usually not a concern and is fairly common. As you progress into your run walk program be sure to slowly taper up your strengthening program including quad strengthening. Take Care!

  9. Alfredo April 29, 2018 at 1:10 am #

    Hello there Doc. Great article and thanks for that. I have been stopped by a light strain in the rectus femoris one week ago. Just one month before my half-marathon on 20th of May. I have mainly rest and immobilized for one week and now wanting to recover quickly. not running yet. Do you recommend static bike or could it be convenient normal ciclyng outdoors? Crawl swimmimg maybe not an option due to the flutter kick, correct?

    • BenShatto April 30, 2018 at 5:33 am #

      Hi Alfredo, I would start with very gently (low resistance) bicycle riding. I would recommend the static or stationary bike first before riding a traditional bicycle. As far as pool work goes. Though you may want to avoid actual swimming I would still try going to the pool and do water walking forwards, backwards and sideways. When tapering back into activities always start slow then taper up the activity.

  10. Amanda April 29, 2018 at 12:01 pm #

    Hello doc! So I do pretty intense HIT and spinning 4 times a week. Is it possible to have strained my vastus medialis from overuse? The inside of my right knee is a little swollen and sore as well as a little higher up, but not much. Just wondering what it could be and I am not having much luck finding anything online. Any advice/feedback would be greatly appreciated!

    • BenShatto April 30, 2018 at 5:37 am #

      HI Amanda, yes it is possible that the inner quad is bothering you, though you could also be getting symptoms of inflammation from knee related issues. If you are getting swelling then it is your bodies way of telling you to slow down. Swelling like that should not occur after normal bouts of exercise. Be sure you are working on your recovery as hard as you work on your fitness.

  11. MD April 30, 2018 at 9:17 pm #

    Hi there! Thanks so much for this great, detailed info! I strained my VMO 5 days ago while doing an intense plyo workout. I didn’t recognize the severity of the injury at first (lesson learned….listen to my body next time!) So I pushed through the pain and limped around for 2 days before going to the doctor. I’ve been doing RICE, using Tylenol/acetaminophen and using crutches for 3 days with little improvement. How will I know when it’s safe to start walking on it again? Or when I can start stretching? I don’t want to rush it and ruin any progress I’ve made but I’m really looking forward to training again (and walking!!! Lol)
    I know from reading your great comments that I should start small and taper up….just wondering how I know when the right time is to start? And what should I start with first? Thank you so much!!!

    • BenShatto April 30, 2018 at 9:57 pm #

      MD,

      Glad to hear the article has bee of help to you. 3 days is not very long for a strain so going slow is advised. As the pain lessens progress down to one crutch and try to walk without a limp. Until you can can walk normal continue with RICE and using crutches. Do not aggressively stretch, only gentle range of motion. Depending on the severity it could be 4-6 weeks before you begin full training again or longer. Pain will guide you, just progress slowly so you can listen to your body. Remember you may not experience pain right away which is why you have to go slow then see how your body responds to the tapered down activity, if all is good slowly taper up a little more the next day. Good luck!!

  12. Talha June 13, 2018 at 3:43 am #

    Hi doc. I had hurt my rectus femoris muscle while doing a shooting drill in soccer. Since then I’ve rested for about 4 months, applied ice and also had physiotherapy sessions too. Now I’ve no problem in running or sprinting but still when I kick the ball with force it still hurts. Can you please tell me why it is happening and some possible remedies. Awaiting your response

  13. Duncan July 13, 2018 at 6:27 am #

    Great article, I will make sure to follow these tips through out my recovery. I am having issues with I think is (google assist) the upper part of the Rectus Femoris,right in the hip flexer area is where I feel it the most. The first time I did it which was about a month and a half ago, I was running and I felt a severe pop sensation then my quad basically locked up on me and I couldn’t pick my leg up, bend it, struggled to walk, jump, even getting in and out of the car. I took it easy for that time, stretched a lot then eventually did some light jogging when possible in hope it would strengthen it. Unfortunately the same incident happened yesterday but not as severe.

    What should I have done differently? Or do I need to go get it checked out?

    Thank you so much.

    • Ben Shatto July 13, 2018 at 9:16 pm #

      Hi Duncan, having a medical professional look at it is always a good idea. But mostly likely you did suffer a tear of one of the hip flexor muscles. I am not a fan of over stretching the area so be careful. Initially I only advise walking, ice and rest. Once the initial pain has improved usually 1-2 weeks continue with walking and ice but then start with soft tissue work to the quad to help it relax and heal, I would then start with a very slow but steady strengthening program focusing on the core muscles, pelvis and legs. I would work on this for 6-8 weeks. No running, only pain free cardio such as water walking, stationary bike or elliptical. Then a depending on the severity of the tear a slow taper back into jogging. Again it all is dependent on the severity of the injury and so the timelines can vary a lot. This is a loose outline. Focus on return to pain free range of motion, don’t over stretch it, then work on strength. Once you are stronger than you were pre injury a very slow taper back into running can be done. I have a thorough outline and rehab protocol available as part of the Resilient Runner Program. Here is the link. https://marathontrainingacademy.clickfunnels.com/optin10735340

  14. Johnna July 16, 2018 at 5:13 pm #

    Hi I pulled my quad muscle at the beginning of June. At the time I didn’t have a specific injury so I kept working out. I go to orange theory about 5 times per week. I’m thinkinf because I have super tight muscles and do not stretch as much as I should is the reason for my Injury. Running maybe. Your article I found so helpful. I’ve been seeing my chiro and doing some stretching foam roller. Haven’t really worked out for a few weeks. My question to u is at orange theory it’s treads/bikes/eliptical. Which one would be the best for me to get back to working out.!!! I’m dying over not being active. I just don’t want to re injure myself. I still cannot run. And how much longer till I’m normal ? Lol any suggestions would be so appreciated

    • Ben Shatto July 16, 2018 at 9:01 pm #

      Hi Johnna, I would trial the elliptical first then the rower. I think the style of interval training they do at Orange Theory is good, but remember fitness is not based on cardio exercise alone. You really need to incorporate some strength training to your routine to help insure a complete recovery and to help prevent re-injury. As you start back to exercise you need to slowly taper the activity. I advise no more than a 10% increase in volume per week until you are back pain free. Keep with the foam rolling but don’t over stretch the injury site. Hope that helps!

  15. Ken Frame August 15, 2018 at 4:00 pm #

    Great article and really tied together all of the misc things I was reading on the internet. I run and mountain bike, among many other sports, including playing softball. I’m 60 yrs old. Played in a tournament this past week end and running to first base the first time up, my left quad area seized up on me… don’t know if I heard or sensed a pop or what. Just know it hurt. Being the team player (stupid reason probably), I finished that game and 3 others that day. We won the championship and I pitched all the slow pitch unlimited arc games. I could still do a slow “jog” to first on a hit and then get a runner, but infield hits… I was an automatic out. Other than feeling something not quite right with my quad area, I’ve been able to continue to walk, go up and down stairs, mow the grass,etc. Even tried riding my bike because I have a short 10 mile race on trail in a week and wondered how it would “feel”. Seemed to be able to bike fine, with little or no discomfort (maybe a 2 on a scale of 1 to 10). Day after the event, I started getting coloring/bruising on the inside of my thigh; by Tuesday on the top of my thigh including the injured area which seems to be about 8″ or so above my knee area. I iced and compressed on Saturday night, Sunday, Monday and have been doing heat with gentle rolling pin/runners stick over the quad in general and usually not over the actual spot. I have no lumps or bumps or issues moving my knee any way I want to. Possibly a small depression (1/2″ deep?)in one spot in that area. Don’t always feel the depression, but sometimes. Trying to figure out where I’m at with Strain level 1, 2 or 3. Real sure I’m not a 3 with all the functionality I seem to have. The coloration is seeming to fade away some on Weds. Trying to decide about that race on Saturday. What are your thoughts on all of the above and my best course of action. Appreciate any advise you can give.

    • Ben Shatto August 15, 2018 at 9:20 pm #

      Hi Ken,

      From your description it sounds like a grade II partial tear. The small divot is likely the area where the quad tore and then of course the bruising helps confirm there was actual tissue damage. It is a very good sign that you have been able to stay so active and not have severe pain, but I would caution you to be easy with the area as further tearing could occur which may lead to more pain and significant disability. So from your description I would back off on some of the activity and be a little more conservative. Allow the area to start the healing process then slowly work into a strengthening program. It’s never wise to risk further injury. I would give it at least 2 weeks then slowly start a strengthening program and taper back into activity. Hope that helps some.

  16. Rob August 25, 2018 at 4:05 am #

    Hope you can help Iv been training for the London marathon and about 2 weeks ago I got a pain in the top of my thigh
    If I’m seated for 10 minuets then stand the pain is there (only slight pain) then after 10 minuets if walking it goes but I can now only manage about 5 miles of jogging
    There is no bruising or swelling just a slight pain on a scale of 1-10 with 10 being the worst I’d say it is a 4
    TIA

    • Ben Shatto August 25, 2018 at 9:04 pm #

      Hi, thanks for the question. This is very interesting as there doesn’t seem to be a specific incident that occurred. That tells me then the pain is likely from over use. This typically happens either due to a muscle imbalance, an issue with gait mechanics or just increasing running volume too quickly. You are going to have to dig a little deeper and try to find the route cause of the pain. But I would start by looking into one of those three things. A true quad strain or pull will usually have a very specific incident where the person knows that a strain has occurred. Best of luck!

      • Rob August 26, 2018 at 1:59 am #

        Thank you for your reply
        I had a video gait analysis done when buying my running shoes and there was an imbalance so they fitted me with the proper supporting shoes needed for my training
        Iv been resting it and it’s slowly getting better I’m just worried that it will happen again

        • Ben Shatto August 26, 2018 at 8:49 pm #

          So the question is what was the imbalance/alteration in gait detected and what kind of shoe did they fit you for to correct it? If it was a motion control shoe and you tend to over pronate then it maybe that you have weakness in her deep hip external rotators that needs to be addressed (for example). You could always have a PT evaluation and have him or her give you a home exercise program to address any potential issues they find.

  17. radha krishna paloju August 29, 2018 at 2:29 pm #

    Hello Ben ,I read the your article regarding “How to Recover Quickly from a Quadriceps Strain” and its very helpful .I am suffering from Quadriceps strain from one month and pain increases when ever I play soccer especially while kicking the ball strong .There is no swelling in the leg but there is pain .How long do I need to take rest and can I start playing using ACE Wrap or other bands around my thigh?

    • Ben Shatto August 30, 2018 at 8:52 pm #

      Hi Radha, good question. If it hurts to kick the ball then you need a few more weeks recovery. I would think 2-3 weeks then wear the ACE wrap and slowly taper into activities. In the mean time work through the suggestions in the post working on mobility and strength of the quadriceps.

      All the best.

  18. Tim August 31, 2018 at 6:12 am #

    Hi Ben, in my left leg I have had multiple ACL injuries. As a result, I often rely on my right leg more due to pain in the left leg. Last weekend, while at a wedding and dancing, I was relying on my healthy right leg a little too much and felt a strain in the right quad. It doesn’t hurt too much, but I do feel weakness in the right quad when walking. However, this morning, while walking the dog, I felt a pull in my left quad muscle near the knee and further up the quad. Is it common for the other (in my case left) quad to experience similar symptoms if it’s compensating for the other (in my case right) quad?

    • Ben Shatto August 31, 2018 at 9:06 pm #

      Hi Tim, good question. Yes it can be common to experience pain in other areas either opposite side or just a different muscle group on the same side. This typically occurs due to compensation trying to avoid the injured area, you change how you typically move and the normal alignment of the body and end of straining something else. The most common example of this is hurting a knee or hip causing a person to limp which then leads to low back pain. So for now I would treat both quads and slow down your movements to help normalize any movement patterns while you recover.

  19. george September 12, 2018 at 2:21 am #

    Hi Ben, i was doing some soccer training and felt a sharp pain in my vastus medialis .after a few days there was a lump and my leg has started shrinking.its been six months and the pain has not subsided ,what should i do or your recommendation?’

    • Ben Shatto September 12, 2018 at 8:56 pm #

      Hi George,

      It sounds like you may have suffered a significant muscle tear. If you have access to medical care I would get a physician’s opinion. If you do not have access to care then I would start a very slow but steady range of motion and strengthening program. If the pain worsens then you will definitely need additional assistance. If you can go slow and slowly improve your strength and the thigh starts to gain in muscle bulk you will know you are headed in the right direction. I hope this helps.

      Ben

      • george September 14, 2018 at 1:57 am #

        would you please advise on some strengthening programs as i look for a physician?

        • Ben Shatto September 14, 2018 at 10:51 am #

          George,
          There are exercises listed in the article. (Please refer to the Strengthening and Rehabilitation Exercises for the Quadriceps.pdf) Once you master these exercises, start a barbell strengthening program that includes squats, lunges, and dead lifts. Start with lighter weights and slowly and progressively increase the resistance as long as there isn’t an increase in pain, swelling or bruising that occurs.

          Ben

  20. Larry J Stone September 14, 2018 at 10:54 am #

    Hey Ben, I am a 65 year old runner and run about 40 miles a week. For the last two months I have had pain in my right quad on the inside of the leg above the knee. It wasn’t any big deal until the last couple of weeks when it got worse. I’m thinking braking to avoid a collusion on the trail is maybe when I hurt it. It gets really bad if I drive all day in a car between braking and hitting the gas. There is no noticible swelling bruising or anything. Any ideas? Should I tape it, Lay off, and can I possibly ride a bike if I lay off. Any ideas would be greatly appreciated. Larry Stone

    • Ben Shatto September 14, 2018 at 9:10 pm #

      HI Larry, Thanks for the question. Its difficult to say just based off that description. If the pain is closer to the knee joint then it is possible that the quad pain is referred from the knee itself. For now I would taper back the running and yes biking can be a good alternative as it provides needed range of motion. Just don’t be too intense with the biking. Thinking of it more like range of motion and improving circulation, not trying to get an intense work out. Give it a week or two then re-evaluate. Also slowly work through the suggestions here or check out my web site or the MTA site and look at Meniscus injury. It might have some helpful advise for you.

  21. Carter September 15, 2018 at 3:03 pm #

    Hey Ben, I’m a kicker for my high school team. For the past four weeks my quadricep has been strained including a knot that runs through my mid quad. I took the last week and half off from doing no kicking, went to a physical therapist for treatment which included building up a tolerance level (strengthening), stretching, stem, massage, using foam roller, etc. The only thing that I improved was lessening the size of the knot in my leg. Unfortunately it was still there but very minimal. I guess my question for you is, why do you think the knot it my quad is still there and not going away?

    This last Friday I kicked for my team because they needed me and now I’m back to square one with my quadricep strained and the knot in my leg inflamed and irritated. I’m not sure if there’s a partial tear and that’s why the muscle is “knotted up” and refusing to go away…possibly the healing process or only result of no pain is a longer recovery:3-4 weeks. Any suggestions would help

    Thanks!

    • Ben Shatto September 16, 2018 at 8:51 pm #

      Hi Carter,

      Yes, I think you are correct. Likely a partial tear which is leading to the knotting. Kicking too soon will just re-aggravate the injury. The fibers that are growing and repairing are fragile and need time to heal. The muscle simply knots up as a self protection mechanism. So even as the knot shrinks you need to be careful. It may be closer to 4-6 weeks depending on the severity. I would take at least 2 weeks and continue with the PT, then if pain is improving go really slow in your progression of strength training for at least 4 weeks then start kicking, but you will have to slowly progress up to full speed. IF you try to push it too fast you are likely just going to re-injure. What did your PT say?

      Ben

      • Carter September 20, 2018 at 9:34 pm #

        They think I should go get an MRI soon…I was able to get some acupuncture done and the specialist thinks that I have a hematoma. He was able to do cupping and acupuncture to bring it to the “surface” to allow it to bruise. If I keep going to pt I think I’ll be able to complete eliminate it and continue to build back strength.

        • Ben Shatto September 21, 2018 at 9:09 pm #

          Carter….sounds like you are on the way to recovery. Definitely keep working on strength and be sure to slowly taper back into kicking once the pain and strength has returned. Quickly too hard to quickly can cause re-injury due to the amount of force involved when kicking. Best of luck!!!!

  22. Kandi October 26, 2018 at 6:56 am #

    Great article! I strained a quad last week training for a trail race. Doing sprints after a half mile jog. Ran 2 gentle miles after that to see how bad it was. Thankfully it was not too painful after but definitely not right. My race is Sunday and I am nervous because I have not run on it all week. Followed your advice here and I’ve been able to swim and do gentle yoga this week without aggravation. Weight bearing on stairs brings it to my attention but only at a mildly annoying level. Hoping to survive the hills and finish my race without further injury.

    • Ben Shatto October 26, 2018 at 9:06 pm #

      Hi Kandi,

      Sorry to hear about your injury. I’m glad the article was helpful. You mention that you can feel the strain when going up stairs. That is a sign that the tissue is definitely still injured. If you intend to run the race this coming Sunday you need to make sure you are really warmed up and that the muscle itself stays “warm”. You may consider wearing a compression sleeve to offer support and to keep the area warm. If the weather conditions are cool you will need to take extra caution. In situations like this the rate of re-injury is high, especially if there are hills in the race. Best of luck!!!

  23. Julia December 9, 2018 at 8:39 am #

    Good afternoon Ben!

    thank you for this informative article I was looking for more iformation on quads, particularly on vastus medialis.

    on November 13th I fell in a garage pit, hit the edge of the pit with my bended knee and landed on my ribs. The injury was more painful on the ribs throughout these weeks, but after three weeks I started to be worried sick about my knee. I wasn’t able to walk, not to mention bending my knee, I can’t lift an extended leg also because if I do it’s so painful in my knee and around it and it feels like something is moving in the knee and there’s cracking sound. but the scariest thing for me that I am not able to move my vastus medialis muscle and it’s still swollen in the area, even the area around my joints is a bit swollen as well. Next week I will make ultra sound examination, because the doctor believes I might have torn the muscle. I can walk now, my other muscles seems to be working, but when I try to bend my leg, the knee area becomes super stiff and a small bump appears near the patella on the inner side as I try and bend it more, so I have to extend my leg quickly because it feels as if that bump will pop out from the skin.

    Is it really possible that my muscle is torn or you think there’s another issue (maybe in my knee joint or patella) that is actually triggering it?

    Thank you again for this article!

    • Ben Shatto December 9, 2018 at 4:35 pm #

      Hi Julia, I’m sorry to hear about your injury. It sounds like you must have taken a very hard fall. From your description it does sound like there could be a significant injury. Based off the information you have provided I would also suspect a possible vastus medialis tear or possibly a fracture of the patella. Either way additional medical follow up should be taken. You wouldn’t want to risk worsening the injury until you know exactly what is wrong. If things were going to improve on their own I would suspect 4 weeks to be long enough. I encourage you to get the follow up so you will have adequate information to know how to progress in your rehabilitation.

      Best of luck. After your scan let us know what they find.

      Ben

      • Julia December 14, 2018 at 4:28 am #

        Hello again Ben!

        I am here to update about my knee injury. So I went for ultra sound yesterday and according to the doctors who conducted the ultra sound I have a few tears in my vastus intermedius muscle, seemed like the tears are in the muscle belly, not the tendon itself. And the bump on the knee, they believe, is a muscle and it pops out near the patella when I try to extend the knee.

        Now I have to wait for appointment with my traumatologist-orthopaedic on December 20th (next Thursday) where he will inform me on possible treatment options.

        Do you have any suggestions in the mean time? I try to rest and not bend my leg, I walk very lightly, don’t want to put too much effort on the leg. I also put some muscle pain relief gel, if the muscles get warm I put some ice for a few minutes. I don’t know whether I should wear a knee/leg brace or elastic band since it’s the deeper muscle and it doesn’t really move that much anyway.

        Have you ever heard of a vastus intermedius tear? Because, as the doctors mentioned, it’s a very rare case.

        Looking forward to your answer and sorry for all the questions, I just find it very frustrating since I’ve never had any serious injury in my life and I am really scared of surgeries.

        Thank you!

        • Ben Shatto December 14, 2018 at 11:13 pm #

          Hi Julia,

          I’m glad you had the ultrasound and they were able to determine the diagnosis. You are correct that this is a more unusual type of injury. The vastus intermedius is deeper into the leg. In most cases the typical treatment is conservative physical therapy treatment. Depending on the severity of the tears it may take many months to fully recover. Typically 3 months or so in therapy and it may be 6 months or so before you are feeling 100% Off course these are just estimates….your personal health status, severity and location of the injury will make a large difference. I would suspect not surgery and conservative management. It just may take a while In the mean time you don’t want to be too aggressive with any movement or activity but if you can alternate heat and ice and do gentle massage and also work on gentle range of motion of the knee. Keep it relatively passive and pain free but you don’t want your knee to get overly stiff if you can help it. Once you start physical therapy and can have a proper evaluation then more specific advice can be given. Best of Luck!!

  24. Aaron Greene December 10, 2018 at 10:03 am #

    As a firefighter I suffer injuries from time to time but I strained my quads less than 72 hours ago and I need to recover quickly but I know rest is what I need but any quick fixes?

    • Ben Shatto December 10, 2018 at 9:56 pm #

      Hi Aaron, That is a tough one. It really depends on the severity of the strain. You don’t want to overwork the area, but you don’t want to let it get stiff and tight either. If it is a Grade I or small Grade II strain you could alternate ice and heat to promote increased blood flow and use a compression wrap to keep the area supported. If you getting a lot of sharp pain be very cautious. If it is just a dull ache you may get away with a little more activity. But always use common sense. Best of Luck!

  25. Rehab December 26, 2018 at 3:14 pm #

    Great article! I strained a quad last week training for a trail race. Doing sprints after a half mile jog. Ran 2 gentle miles after that to see how bad it was. Thankfully it was not too painful after but definitely not right. My race is Sunday and I am nervous because I have not run on it all week. Followed your advice here and I’ve been able to swim and do gentle yoga this week without aggravation. Weight bearing on stairs brings it to my attention but only at a mildly annoying level. Hoping to survive the hills and finish my race without further injury
    Thanks.

    • Ben Shatto December 30, 2018 at 9:47 pm #

      Thank you! Wish you the best of luck on your race. Let us know how it goes!

  26. Michelle February 14, 2019 at 4:12 pm #

    Hi there,

    I am marathon training for a race in May (May 11th) and I think I strained my quad or hip flexor squatting a 45# bar without warming up. There was a sudden pain like a cramp in my right leg on the outside of my quad by the hip. It is still tender to the touch and I’m having trouble lifting my right leg up into a quad stretch position. Air squatting and stretching feel okay but hurt after.

    It looks like I need to rest the muscle for at least a week or two, is there anything I can do to keep up cardio conditioning? Is it still reasonable to expect to run a marathon in 3 months time and if so how would you recommend ramping up the running once I am no longer in pain? I am by no means an experienced runner, this would only be my second marathon (my first was last October) so I am quite dependent on my training program to ensure I’m in shape to run.

    Thank you!

    • Ben Shatto February 14, 2019 at 10:12 pm #

      Hi Michelle,

      It does sound like you may have strained the quad. 3 months is plenty of time to get in shape for the race since you likely have a base already having been running and doing a race last October. Take time to rest and work on maintaining the range of motion in the leg. I wouldn’t worry too much about the cardiovascular side of things right now given you have 3 months to train. Focus on getting the leg healthy. Once you can start to jog without pain just tapper back into the running plan. You may start back a few weeks and once your feeling 100% then stair step back into the appropriate week on the plan. In the mean time work on your core strengthening and other cross training that does not cause too much soreness.

      Keep us posted!

      • Michelle February 24, 2019 at 7:39 am #

        thanks Ben,

        I waited about 10 days from the original injury when I could walk briskly without pain and after a mile warm up I lightly jogged a mile without pain. I rested the next day and then warmed up and tried for two miles. At 1.8 my leg stiffened and then my quad tightened/cramped so badly I had to stop. There was no warning other than the usual(symmetrical) burn from running.

        I iced it last night and it still feels tender and sore on the front of my leg and back by the hip. Is It possible that I worsened the injury even though I stopped when it hurt or should I be back to normal once it quiets down? I am uncertain if this is normal or if it means I am attempting too much too soon. Should i go back to resting and light walking for another week (or longer?) before I try to jog again or just wait until the pain subsides and try a more gradual increase?

        Thank you!

        • Ben Shatto February 24, 2019 at 5:09 pm #

          Hi Michelle,

          Based off the information provided it does sound like you re-strained the injury. It depends on the severity but with you re-straining after approximately 2 weeks I would suspect a grade 2 tear. Now grade 2 tears can vary wildly on severity but I would be very cautious with an early return to running. At this point I would target at least 4 weeks of rehab and no running and it maybe up to 8 weeks depending on how it is feeling. Then it has to be a very slow and gradual return to running. But first you have to have full range of motion and pain free use of the leg with squatting and the rehab exercises. Likely tapering up at 1/2 mile increments when you do return to jogging. Going slower now will help insure you don’t continue to re-injury and then have an extended recovery later. I hope that helps!

          Ben

          • Michelle February 24, 2019 at 9:48 pm #

            Thanks Ben,

            Just to confirm that I understand the timeline is it best to wait 4 weeks from today before I try running again or did you mean from the initial injury?

            I feel much better after a day of total rest and the quad is no longer tender and walking is pain free.

            However, my hips are tender and lower back is sore on both sides, is is possible that I strained that too or is it common to experience tightness due to compensation? I was thinking of scheduling a doctors appointment but the pain is mild enough that is doesn’t seem warranted.

            Do you think hip focused yoga would be okay if I avoided painful stretching or should I stick to the rolling mentioned in the article?

            I will stick to walking and swimming for now, would the elliptical or biking also be good options or do you think that would be too straining?

            Thanks!

            • Ben Shatto February 26, 2019 at 10:01 pm #

              Hi Michelle,

              It is tough to give specific advice without a thorough evaluation. In general you need to be pain free for several days before you return to running. Especially since it re-strained so easily the first time. The additional muscle soreness is common. During this time try to address any pre-existing issues that may be contributing factors to your injury. I would not over stretch the injury site but I would want to see full range of motion prior to your return to running. I would suggest at least a 2 week break before you taper back into running. In the mean time continue with the rehab including swimming. You could try the elliptical but I would be hesitant about yoga for the short term. The timing is only loose guidelines based on how you feel. But it is always better to taper back into things slowly and not rush. Best of luck.

  27. Chris February 23, 2019 at 4:26 am #

    Hi Ben. I was performing forward lunges in my body pump class when I felt a loud pop at the top front of thigh. As it was near the end of the class I finished off and everything was fine. Did exactly the same thing this week. Loud pop, same place, near end of class. Went home and put ice on. Big red mark where the pop happened and slight swelling. Warm thigh and slight pulling when I walk but no restriction in movement and not really any pain. I thought a loud pop meant it was a grade 3 tear but I have none of the symptoms of this. Any ideas?

    • Ben Shatto February 24, 2019 at 5:03 pm #

      Hi Chris, There are lots of reasons to feel or hear a popping sound. If you are feeling this at the the top of thigh I am assuming you are meaning hear the front of the hip or hip flexor area. In this area you can get popping from the tendon as it slides over the bone, or even popping from inside the hip from a small labral tear. If a true Grade 2 or 3 muscle tear has occurred you are likely to not only see swelling but likely bruising and I would suspect there would be loss of motion and pain when using the muscle. My guess based off the information provided is that this is likely a hip /hip flexor issue and not a true quad tear/strain. Hope that helps!

  28. Steven O. March 28, 2019 at 9:31 am #

    Hi, Ben. Great article. I believe I have a Grade I/II Vastus Medialis strain/tearon Tuesday (3/26/19). Little background of the event: I was working a strength complex of two push-press and one push-jerk (all heavy weight ~ 90-95% of one rep max), 5 sets of this complex. On the last set, I believe I had 190/195lbs on the barbell, I got the first push-press up with elbows locked out, but on the second one I got the weight up but I think I may have leaned a little too far forward with a lot of the force/weight loading my front quad area. I felt a pop in the mid-quad area, I was able to finish the push-jerk though. The immediate feeling of pain was minimal, maybe 5 out of 10. I continued with the workout which included 6 strict pull-ups, 10 dumbbell snatches, 13 sit-ups for 5 rounds. Since then, I took Wednesday (3/27/19) off and stayed home – I kept my activity real low by laying on the couch/bed with icing the area and elevation. Ive also been applying pressure when ice isnt applied. Icing has been on for 15-20 min every hour. The vastus medialis area is sore, no apparent bulge but there is swelling. It does hurt on the interior side when I try to squat (body weight). Any recommendations on a quicker recovery? I was planning on taking it easy (no lower body workouts) for the next 2-3 weeks.

    • Ben Shatto March 28, 2019 at 9:11 pm #

      HI Steven…definitely sounds like a Grade I or even a grade II strain. You need to keep the range of motion in the leg but do not be too aggressive with stretching. It has to be a balance of motion and not too much pain. For the first week or two no aggressive foam rolling but you can definitely massage and foam roll above and below the injury. Continue with icing and compression for at least the first week. Your first goal should be able to perform a partial body weight squat no pain. Then progress to a bicycle with low resistance for the range of motion and to promote blood flow. Be very gentle as you test your limits. If you push too hard too fast it will re-injure and prolong the recovery. Once you can body weight squat (full squat) then slowly start loading the bar. No quick movements like box jumps or wall balls till you are 100% pain free then progress slowly. Depending on the severity this may take 6-8 weeks. If there is any pain with slow movements then definitely avoid quick motions. Typically its a quick motion that will cause a re-injury. Hope that helps!

  29. Joe April 2, 2019 at 4:17 pm #

    Hi

    I felt a pull on my quad on Wednesday night playing football (soccer) felt perfectly fine after words and never thought anything of it, until Monday night back at football and I felt a much worse pull on the same quad, and it now feels very right and painful, could I have done a lot more damage to myself?

    • Ben Shatto April 2, 2019 at 8:51 pm #

      Hi Joe,

      Sounds like you had an initial mild strain and likely now re-strained the area but possibly worse. I would anticipate several weeks at least for a recovery and follow the advice in the article. If you push it again it could lead to an even worse injury…..so please be careful as you return to sport. All the best!

      Ben

  30. Immigration attorney April 24, 2019 at 9:54 am #

    Hi Ben Shatto,
    Strains can range from a mild discomfort to a full blown tear of most of the muscle which can result in severe pain and the inability to run or walk. The injury typically happens when one or more of the quadriceps muscles become overloaded.
    Thanks.

  31. Joe Quinn June 1, 2019 at 9:45 am #

    Hi Ben

    Great article. Best I’ve found on the subject. I’m 60 years old, former runner now grounded due to osteoarthritis in both hips.

    I’ve started my own stretching and muscle strengthening programme for my hips. One exercise is a straight leg raise with a 1 kilo weight strap on my ankle. I’m really not clear on how often I should do the strengthening exercises but I’ve been doing them 5-6 days a week, 15 reps per leg.

    I reckon this is what has caused the pain in my right thigh that occurs after walking about 20 meters and forces me to stop. There wasn’t a dramatic event that caused this. From studying your posts above, I reckon it is the overuse that has caused this.

    Two questions:
    1. How long would I need to recover from this?
    2. How often should I do muscle strengthening exercises?

    • Ben Shatto June 1, 2019 at 3:59 pm #

      HI Joe,

      Thanks for the compliment. From your description the injury is likely overuse in nature. Because of the nature of the injury there is likely not a lot of muscle fiber disruption but more likely an inflammatory process that is causing more of the pain. I would suspect 2-3 weeks on the short side up to 4-6 weeks on the long side for recovery. This of course assumes that the exercise was the actual source of the pain and there are not other complicating factors. True strengthening exercises do not need to be done more than 2-3 times a week. Though it is critical to engage in some form of activity daily. And daily range of motion is critical for arthritic joints.

      Here is a link to another article on hip pain you may find beneficial. Best of luck!

      Ben

      https://www.marathontrainingacademy.com/hip-flexor-pain

  32. Sam June 10, 2019 at 1:43 am #

    Hi ben, i had a mid thigh muscle strain 3 years ago while sprinting.am an overweight(130kg) young man, had an argument with some guy about who is faster and went straight into the track without warming.its not painful when am walking but whenever i run or put weight on the thigh it starts to lose strength and it sort of starts to cramp.

    • Ben Shatto June 10, 2019 at 8:54 pm #

      Hi Sam,

      Not entirely sure of your question but it does sound like you may have injured your quad. If it is still bothering you after 3 years it is likely due to a lack of adequate rehabilitation. I would recommend a slow and steady approach to strengthen and mobilize the area, while loosing weight to take strain off the lower extremities. Best of luck!

      Ben

  33. Mani August 15, 2019 at 2:35 am #

    Hi ben,

    I was doing spin cycling at the gym about one month back and felt a mild pain near the hip specially when im lifting my leg. I saw a doctor later and he told it was a quad strain. I had been resting for a week after, while keeping ice twice a day. i felt normal and could raise my leg without a pain. Then i started brisk walking and got the pain back again while lifting my leg (i can walk without an issue). Does this mean i have re-injured my quad? How long should i rest and how do i know its fully healed?

    • Ben Shatto August 15, 2019 at 9:01 pm #

      Hi Mani, Most likely this means the injury has not fully healed and though you are now able to do low level activities the muscle is not yet ready to handle activities that require more load or speed. I would keep with the incing and follow the exercises noted. Every week slowly test your limits to see how you are progressing. But be careful to not over do or you do risk re-injury. Ben

  34. Ruta September 4, 2019 at 2:19 pm #

    Hi Ben,

    My son injured his hip playing soccer back in February. (No “popping” or such that he can remember, just remembers that it hurt.) After the initial injury, he tried to play through for a few weeks but eventually the pain was too great, so he rested for a few weeks. Then he started lifting weights and couldn’t squat and his range of motion was limited, so he went on total rest for about 6 weeks. He tried to slowly resume activity but he was still really uncomfortable with any hip movement, running, squatting, etc.

    We saw an orthopedist in June (no MRI) who said it seemed that he had a strained / torn rectus femoris @ the insertion, and prescribed physical therapy. Six weeks of physical therapy, and my son felt better and stronger, got the OK to return to sports in August, almost exactly one month ago. But his hip soon became irritated again, even with frequent icing, wrapping, and lots of stretching — and irritation has turned to pain, and now he is saying the pain is pretty acute. So we’re going back to the orthopedist ASAP, but in the meantime, any ideas? It seems like something isn’t right here.

    Thanks so much.

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